Structure and function of the circulatory system
Anatomy of the heart
Excitatory, conductive and contractile elements of the heart
The Cardiac Cycle
The foetal circulation
Circulatory and respiratory changes that occur at birth
Electrical Properties of the Heart
Normal processes of cardiac excitation and electrical activity
Ionic basis of spontaneous electrical activity of cardiac muscle
Abnormal processes of cardiac excitation and electrical activity
Determinants and Control of Cardiac Output
Components and determinants of cardiac output
Definitions of preload afterload and contractility
Determinants of preload
Determinants of afterload
Determinants of contractility
The Frank-Starling mechanism
Cardiac output curves and vascular function curves
The concept of venous return
The concept of mean systemic filling pressure
Ventricular pressure-volume loops
Myocardial oxygen supply and demand
The Peripheral Circulation
Systolic, diastolic and mean arterial blood pressure
Factors which affect peripheral vascular resistance
Factors which contribute to pulse variation
Physiological factors which contribute to central venous pressure
Mixed venous oxygen and carbon dioxide content
The relationship of venous oxygenation and cellular metabolism
Practical use of central and mixed venous blood gases
Regional Circulation
Essential features of the microcirculation
Starling forces and fluid exchange in the microcirculation
Autoregulation within peripheral circulations
Cerebral blood flow autoregulation
Hepatic blood flow
Coronary blood flow
Renal blood flow
Splanchnic blood flow
Regional skeletal muscle blood flow
Uteroplacental blood flow
Portal systems in the regional circulation
Control of the Circulation
Cardiac reflexes
Function of baroreceptors and clinical relevance of the baroreflex
Role of the vasomotor centres
Catecholamine vasopressors and inotropes
Noradrenaline
Dobutamine
Non-Catecholamine Vasopressors and Inotropes
Vasopressin
Milrinone
Principles of Pressure Measurement
Pressure transducers for haemodynamic measurements
Resonance, damping and frequency response
Arterial pressure monitoring
Factors involved in site selection for arterial cannulation
Indications and contraindications for arterial line insertion
Arterial cannulation equipment
Arterial cannulation technique
Complications of arterial cannulation
The arterial line pressure transducer setup
Arterial line dynamic response testing
Normal arterial line waveforms
Interpretation of abnormal arterial line waveforms
Central Venous Pressure Monitoring
Central venous pressure measurement
The relationship of CVP to right ventricular preload
Interpretation of the central venous pressure waveform
Abnormal central venous pressure waveform patterns
Pulmonary Artery (Swan-Ganz) Catheter
Anatomy of the pulmonary artery catheter
Insertion of the pulmonary artery catheter
Troubleshooting the insertion of the pulmonary artery catheter
Indications, contraindications and complications of pulmonary artery catheter insertion
Physiology of pulmonary artery wedge pressure measurement
Assumptions upon which rests the validity of pulmonary artery wedge pressure measurement
The relationship of PAWP to left atrial pressure
Pulmonary artery diastolic pressure
Measurement of pulmonary capillary hydrostatic pressure
The Stewart-Hamilton Equation for measuring cardiac output
Fick's Principle of cardiac output measurement
Equations describing the derived haemodynamic parameters
Thermodilution measurement of cardiac output with the pulmonary artery catheter
Using the PA catheter in the diagnosis of hemodynamic instability
PiCCO: Pulse Contour Cardiac Output Monitoring
Transpulmonary thermodilution for cardiac output measurement
Pulse contour cardiac output measurement
Stroke volume variation
ITTV: the intra-thoracic thermal volume
PTV: the pulmonary thermal volume
Relationship of downslope time and pulmonary thermal volume
GEDV: global end-diastolic volume
ITBV: intrathoracic blood volume
EVLW: extravascular lung water volume
A summary of PiCCO variables and normal values
PiCCO-guided resuscitation of shock
LiDCO: lithium dilution cardiac output measurement
Sonographic Assessment of Haemodynamic Performance
The Simpson method of stroke volume estimation
LVOT Doppler for estimation of cardiac output
Continuous oesophageal Doppler for estimation of cardiac output